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Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis

An understanding of the epidemiology of poststroke dementia (PSD) is necessary to inform research, practice and policy. With increasing primary studies, a contemporary review of PSD could allow for analyses of incidence and prevalence trends. Databases were searched using a prespecified search strat...

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Autores principales: Craig, Louise, Hoo, Zhi Liang, Yan, Toh Zeng, Wardlaw, Joanna, Quinn, Terence J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784999/
https://www.ncbi.nlm.nih.gov/pubmed/34782389
http://dx.doi.org/10.1136/jnnp-2020-325796
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author Craig, Louise
Hoo, Zhi Liang
Yan, Toh Zeng
Wardlaw, Joanna
Quinn, Terence J
author_facet Craig, Louise
Hoo, Zhi Liang
Yan, Toh Zeng
Wardlaw, Joanna
Quinn, Terence J
author_sort Craig, Louise
collection PubMed
description An understanding of the epidemiology of poststroke dementia (PSD) is necessary to inform research, practice and policy. With increasing primary studies, a contemporary review of PSD could allow for analyses of incidence and prevalence trends. Databases were searched using a prespecified search strategy. Eligible studies described an ischaemic or mixed stroke cohort with prospective clinical assessment for dementia. Pooled prevalence of dementia was calculated using random-effects models at any time after stroke (primary outcome) and at 1 year (range: 6–18 months), stratified for inclusion of prestroke dementia. Meta-regression explored the effect of year of study. Sensitivity analyses removed low-quality or outlier studies. Of 12 505 titles assessed, 44 studies were included in the quantitative analyses. At any time point after stroke, the prevalence of PSD was 16.5% (95% CI 10.4% to 25.1%) excluding prestroke dementia and 22.3% (95% CI 18.8% to 26.2%) including prestroke dementia. At 1 year, the prevalence of PSD was 18.4% (95% CI 7.4% to 38.7%) and 20.4% (95% CI 14.2% to 28.2%) with prestroke dementia included. In studies including prestroke dementia there was a negative association between dementia prevalence and year of study (slope coefficient=−0.05 (SD: 0.01), p<0.0001). Estimates were robust to sensitivity analyses. Dementia is common following stroke. At any point following stroke, more than one in five people will have dementia, although a proportion of this dementia predates the stroke. Declining prevalence of prestroke dementia may explain apparent reduction in PSD over time. Risk of dementia following stroke remains substantial and front-loaded, with high prevalence at 1 year post event.
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spelling pubmed-87849992022-02-04 Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis Craig, Louise Hoo, Zhi Liang Yan, Toh Zeng Wardlaw, Joanna Quinn, Terence J J Neurol Neurosurg Psychiatry Neurodegeneration An understanding of the epidemiology of poststroke dementia (PSD) is necessary to inform research, practice and policy. With increasing primary studies, a contemporary review of PSD could allow for analyses of incidence and prevalence trends. Databases were searched using a prespecified search strategy. Eligible studies described an ischaemic or mixed stroke cohort with prospective clinical assessment for dementia. Pooled prevalence of dementia was calculated using random-effects models at any time after stroke (primary outcome) and at 1 year (range: 6–18 months), stratified for inclusion of prestroke dementia. Meta-regression explored the effect of year of study. Sensitivity analyses removed low-quality or outlier studies. Of 12 505 titles assessed, 44 studies were included in the quantitative analyses. At any time point after stroke, the prevalence of PSD was 16.5% (95% CI 10.4% to 25.1%) excluding prestroke dementia and 22.3% (95% CI 18.8% to 26.2%) including prestroke dementia. At 1 year, the prevalence of PSD was 18.4% (95% CI 7.4% to 38.7%) and 20.4% (95% CI 14.2% to 28.2%) with prestroke dementia included. In studies including prestroke dementia there was a negative association between dementia prevalence and year of study (slope coefficient=−0.05 (SD: 0.01), p<0.0001). Estimates were robust to sensitivity analyses. Dementia is common following stroke. At any point following stroke, more than one in five people will have dementia, although a proportion of this dementia predates the stroke. Declining prevalence of prestroke dementia may explain apparent reduction in PSD over time. Risk of dementia following stroke remains substantial and front-loaded, with high prevalence at 1 year post event. BMJ Publishing Group 2022-02 2021-11-15 /pmc/articles/PMC8784999/ /pubmed/34782389 http://dx.doi.org/10.1136/jnnp-2020-325796 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Neurodegeneration
Craig, Louise
Hoo, Zhi Liang
Yan, Toh Zeng
Wardlaw, Joanna
Quinn, Terence J
Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title_full Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title_fullStr Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title_full_unstemmed Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title_short Prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
title_sort prevalence of dementia in ischaemic or mixed stroke populations: systematic review and meta-analysis
topic Neurodegeneration
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784999/
https://www.ncbi.nlm.nih.gov/pubmed/34782389
http://dx.doi.org/10.1136/jnnp-2020-325796
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